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Benefits & Exclusions
Patriot America® | Patriot International®
Take the Uncertainty Out of International Travel with World Travel Insurance
International travel is supposed to be an exciting adventure. Don’t get caught in a bind without quality travel or travel health insurance; travel abroad poses enough of its own unpredictable situations. One of the most serious risks is injury or illness in a foreign country. Unfamiliarity with a different culture and its medical system is intensified without the proper resources to assist you when you need medical care. Traditional medical plans offer fine domestic coverage, but few are designed for international use. Even those that offer limited benefits do not normally cover medically supervised emergency evacuations, emergency reunions or repatriation. Additional complications can arise because of different languages, currency conversion, inexperienced international claims administration, and time differences. Imagine trying to get in touch with most insurance companies at 3:00 a.m. on a weekend … from a foreign country … during a medical emergency!
New York International Group is dedicated to eliminating these uncertainties from international travel by making available affordable, cheap medical insurance with convenient international service. There are three different Patriot Travel Medical Insurancesm plans available (including terrorism insurance – do note that restrictions apply). At enrollment, you simply pick the plan that applies to your citizenship and travel plans. Patriot Travel Medical Insurancesm provides up to US$1,000,000* of medical expense coverage, up to US$25,000 in Accidental Death and Dismemberment coverage, a complete assistance package of
Benefits
Medical Benefits: Usual reasonable and customary charges,
subject to deductible and coinsurance
| Hospital Room
and Board |
To Policy Maximum for average semi-private room rate |
| Intensive Care |
To Policy Maximum |
| Medical Expenses |
To Policy Maximum |
| Outpatient Medical |
To Policy Maximum |
| Local Ambulance |
To Policy Maximum |
| Emergency
Room |
As Described Below |
Charges incurred for the use of the Emergency
Room due to an accident are covered up to the Policy Maximum.
Charges incurred for the use of the Emergency Room for treatment
of an illness are subject to an additional (extra) US$250 deductible
if treatment does not require admittance to the hospital. |
| Dental |
As
Described Below |
Injury due to an accident: Each Patriot
plan covers the cost of emergency dental treatment and dental procedures
necessary to restore sound natural teeth lost or damaged in an accident
up to the Policy Maximum.
Sudden dental pain:
Each plan will pay up to US$100 for the necessary treatment of sudden,
unexpected pain to sound natural teeth. |
| International Emergency Care |
| Emergency Evacuation |
To
Policy Maximum When coordinated through Plan Administrator |
| Each Patriot Travel Medical Insurance® plan includes
coverage for Emergency Medical Evacuations to the nearest qualified
medical facility; expenses for reasonable travel and accommodations
resulting from the evacuation; and the cost of returning to either
the country of residence or the country where the evacuation occurred,
up to the policy limit. |
| Emergency Reunion |
To
US$15,000 when coordinated through Plan Administrator |
Each Patriot® plan also provides emergency reunion
coverage, up to US$15,000 for a maximum of 15 days, for the reasonable
travel and lodging expenses of a relative or friend during an Emergency
Medical
Evacuation: either the cost of accompanying the insured during the
evacuation or traveling from the country of residence to be reunited
with the insured. |
| Reparation |
To
US$25,000 when coordinated through Plan Administrator |
| If a covered illness/injury results in death, expenses
for Repatriation of bodily remains or ashes to the country of residence
will be covered up to a maximum of US$25,000. |
| Political Evacuation |
To
US$10,000 when coordinated through Plan Administrator |
If the United States Department of State, Bureau of Consular Affairs issues a travel advisory that becomes effective on or after the Insured Person’s date of arrival in the Host Country, the Company will pay up to US$10,000 for transportation to the nearest place of safety or for repatriation to the Insured Person’s home country or country of residence provided that:
- The Insured Person contacts the Company within 10 days of the United States Department of State, Bureau of Consular affairs issues the travel advisory;
- Political Evacuation and Repatriation is approved and coordinated by the Company.
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| Plan Information |
| Deductible |
Your
choice of US$0, $100, $250, $500, $1,000 or $2,500 |
| Coinsurance |
As
Described Below |
For treatment received outside the US &
Canada: No coinsurance
For treatment
received within the US & Canada:
Inside the PPO Network the plan pays 90%
of eligible expenses up to US$5,000, then 100% up to the Policy
Maximum
Outside the PPO Network the plan pays 80% of
eligible expenses up to US$5,000, then 100% up to the Policy Maximum |
| Benefit Period |
Six
(6 ) Months |
| If a covered injury or illness requires continuing
treatment after the Period of Coverage expires, the six-month Benefit
Period may provide continued coverage. When the certificate expires,
the Company will review the date of initial treatment for the covered
injury or illness. If treatment began less than six months before
the Period of Coverage expired, benefits for the covered injury
or illness will continue subject to the Policy Limits and the other
terms of the plan until there have been six months of continuous
coverage for the covered injury or illness. |
| Additional Benefits |
| Home Country Coverage |
As
Described Below |
Incidental Home Country Coverage - During
the Period of Coverage an insured person may return to their country
of residence for incidental visits up to a cumulative two weeks
total, subject to: a. The insured person must have left their country
of residence, b. The total Period of Coverage must be for a minimum
of 30 days, and c. The return to the country of residence may not
be taken to receive treatment for an illness or injury incurred
while traveling.
End of Trip Home Country Coverage
- For every five months of continuous coverage you purchase,
you can purchase one additional month of home country coverage as
an accommodation and supplemental travel benefit, up to a maximum
of two months. To purchase this special home country extension coverage,
please check the appropriate box on the Application Form, and calculate
your premium to include the additional month(s). |
| Trip Interruption |
To
US$5,000 |
| If, during a covered trip, there is a death of an
immediate family member (spouse, child, parent or sibling) or the
substantial destruction of the insured’s principal residence,
each Patriot plan will pay to return the insured to the area of
principal residence. The plan will pay for a one way air or ground
transportation ticket of the same class as the unused travel ticket,
less the value of the unused return ticket. |
| Lost Luggage |
To US$50 per item or personal property; maximum of US$250 per
Period of Coverage |
| This benefit will be paid in the event that the Common
Carrier permanently loses an insured person’s checked luggage.
This coverage is secondary to any other available coverage, including
the Carrier’s. |
| Common Carrier
Accidental Death |
US$50,000
to Beneficiary; maximum of US$250,000 per family |
| If accidental death should occur while traveling on
a commercial Common Carrier, US$50,000 will be paid to the designated
beneficiary, to a maximum of US$250,000 per family. |
| Sports & Activities Coverage
|
To
Policy Maximum for basic and extreme sports as described below |
Each Patriot plan covers injuries incurred
during amateur athletic activities which are non-contact and engaged
in by the insured person solely for leisure, recreation, entertainment
or fitness purposes. However, activities not covered include amateur
or professional sports or other athletic activity which is organized
and/or sanctioned, or which involves regular or scheduled practices,
games or competition.
The following hazardous activities are excluded: racing of any kind,
aviation (except when traveling as a passenger in a commercial aircraft),
BMX, BASE jumping, bobsleigh, bungee jumping, canyoning, caving,
high diving, hang gliding, heli-skiing, hot air ballooning, inline
skating, jet skiing, kayaking, luge, motocross (moto-x), mountain
biking, mountaineering, parachuting, rappelling, rock climbing,
rodeo, scuba diving, ski jumping, sky diving, snow skiing, snowboarding,
snowmobiling, spelunking, snorkeling, surfing, wakeboarding, water
skiing, windsurfing and whitewater rafting.
Optional
Sports Rider: This rider adds coverage for jet skiing, scuba diving,
snow skiing, snowboarding, snowmobiling, snorkeling, surfing, wakeboarding,
water skiing and windsurfing. For more sports coverage, please review
IMG’s Patriot Extreme® plan. |
| Terrorism Coverage
|
To
Up to US$50,000 lifetime maximum |
Each Patriot plan provides coverage for injuries and illness incurred as a result of an act of Terrorism, limited in amount and by circumstances. If an insured person is injured as a result of an act of Terrorism, and the insured person has no direct or indirect participation in the act, the plan will reimburse eligible medical claims subject to a US$50,000 lifetime maximum. However, claims incurred as a result of radiological, nuclear, chemical or biological weapons or events are not covered.
Terrorism is defined as the systematic or planned use of violence, fear, or threat of violence in order to intimidate a population or government, especially as a means of coercion or to obtain a granting of any demand. However, this benefit does not cover an act of Terrorism in any country or location where the United States government has issued a travel advisory that has been in effect within the 6 months prior to the insured person's date of arrival.
This benefit also does not cover an act of Terrorism in the event that an
advisory to leave a certain country or location is issued by the United States
government after the insured person's arrival date, and the insured person
unreasonably fails or refuses to depart the country or location.
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| Accidental
Death & Dismemberment |
US$25,000
principal sum |
| Each Patriot plan includes US$25,000
principal sum benefit for Accidental Death and Dismemberment occurring
during the Period of Coverage: • Accidental Loss of life -
principal sum; • Accidental Loss of two Members - principal
sum; • Accidental Loss of one Member - 50% of principal sum.
“Member” means hand, foot or eye. For more information,
see the Conditions of Coverage section on page 14 of the Patriot
Travel Medical Insurance brochure. |
| Additional Benefits
for U.S. Citizens |
| Sudden Recurrence
of a Pre-existing Condition |
| Up to US$15,000 will be paid for the
eligible expenses of a sudden and unexpected recurrence of a Pre-existing
Condition while traveling outside of the US. In addition, up to
US$25,000 will be paid for the eligible costs and expenses of an
Emergency Medical Evacuation arising or resulting from a sudden
and unexpected recurrence of a Pre-existing Condition. For the definition
of a Pre-existing Condition, please see the Patriot Travel Medical Insurance brochure. |
| Indemnity |
| Patriot International will pay directly
to the insured person US$100 for each night of a required overnight
stay in a hospital. However, the hospital stay must be covered under
this plan in order to receive this benefit. |
Exclusions
Charges for the following services, treatments and/or conditions, among others,
are excluded from coverage under the Patriot plans.
1. Pre-existing Conditions. A pre-existing condition is defined as any
injury, illness, sickness, disease, or other physical, medical, mental
or nervous condition, disorder or ailment that, with reasonable medical
certainty, existed at the time of application or at any time during the
three years prior to the effective date of the insurance, whether or not
previously manifested or symptomatic, diagnosed, treated, or disclosed
prior to the effective date, including any subsequent, chronic or recurring
complications or consequences related thereto or arising therefrom.
2. Treatment or surgeries which are elective, investigational, experimental
or for research purposes.
3. War, military action, terrorism, political insurrection, protest, or
any act thereof. The Company will not pay for a Political Evacuation if there is a travel advisory in effect on or within six (6) months prior to the Insured Person’s date of arrival in the Host Country.
4. Immunizations and routine physical exams.
5. Treatment of Temporomandibular Joint or dental treatment, except as
expressly provided for in the certificate of insurance.
6. Venereal disease, AIDS virus, AIDS related illness, ARC Syndrome, or
AIDS, and the cost of testing for these conditions, and charges for treatment
or surgeries which are incurred by any Insured who was HIV+ at time of
enrollment into this insurance.
7. Pregnancy, childbirth, birth control, artificial insemination, treatment
for infertility or impotency, sterilization or reversal thereof, or abortion.
8. Injury sustained while participating in amateur or professional sports
or other athletic activity which is organized and/or sanctioned, or which
involves regular or scheduled practices, games or competition. The following
hazardous activities are excluded: racing of any kind, aviation (except
when traveling as a passenger in a commercial aircraft), BMX, BASE jumping,
bobsleigh, bungee jumping, canyoning, caving, high diving, hang gliding,
heli-skiing, hot air ballooning, inline skating, jet skiing, kayaking,
luge, motocross (moto-x), mountain biking, mountaineering, parachuting,
rappelling, rock climbing, rodeo, scuba diving, ski jumping, sky diving,
snow skiing, snowboarding, snowmobiling, spelunking, snorkeling, surfing,
wakeboarding, water skiing, wind-surfing and whitewater rafting.
9. Vision or ear tests and the provision of visual or hearing aids.
10. Vocational, recreational, speech or music therapy.
11. Treatment while confined primarily to receive custodial care, educational
or rehabilitative care, or nursing services.
12. Charges, injuries and/or illnesses resulting or arising from or occurring
during the commission or continuing perpetration of a violation of law
by the insured, including without limitation, the engaging in an illegal
occupation or act, but excluding minor traffic violations.
13. Treatment for, and injuries and/or illnesses resulting or arising
from, substance abuse or drug addiction.
14. Injury and/or illness resulting or arising from or sustained while
under the influence of or disablement of drugs or alcohol.
15. Willful self-inflicted injury or illness.
16. Treatment required as a result of or arising from complications from
a treatment or condition not covered under the certificate.
17. Any services or supplies performed or provided by a relative of the
Insured or provided at no cost to Insured.
18. Treatment for mental and nervous disorders.
19. Organ or tissue transplants or related services.
20. Illness or injury where the trip to the host country is undertaken
for treatment or advice for such Illness or injury, except as expressly
provided for in the certificate of insurance.
21. Treatment incurred as a result of or arising from exposure to nuclear
radiation, and/or radioactive material(s).
This web page contains only a consolidated and summary
description of all current Patriot Travel Medical Insurance benefits,
conditions, limitations and exclusions. A certificate containing the complete
Policy Wording with all terms, conditions and exclusions will be included
with the fulfillment kit. IMG reserves the right to issue the most current
Policy Wording for this insurance plan in the event this application and/or
brochure has expired, is modified, or is replaced with a newer version.
Current Policy Wordings are available upon request.
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